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CHOLELITHIASIS. BILIARY CALCULI. GALL
STONES.

In ruminants, omnivora, and carnivora, less often in horse, 1 to 1000, or more,

biliary sand to marble or more, casts; nucleus, bile pigment, blood mucus, etc.,
with concentric layers of cholesterine, pigment, salts and lime. Causes: idleness,
overfeeding, dry feeding, thickening of bile, colloids, bacteria, wintering in stable.
Colloids induce globular deposits. Parasites. Inflamed biliary epithelium secretes
excess of cholesterine and lime. Age. Acid bile, constipation. Diseased liver. Lack of
bile salts. In solipeds: all sizes and numbers, green, brown, yellow or white. Liver
disease. Symptoms: colic with depression, prostration, yellow or red urine, icterus,
sudden recovery. Treatment: sulphate of soda, olive oil, antispasmodics, warm
drinks, fomentations, salicylate of soda, chloroform, pasture, or succulent food,
and open air exercise. In cattle: musk odor; calculi dark green, yellowish green,
whitish or orange, dry red, all sizes and numbers. Causes: dry winter feeding, etc.
Lesions: dilated biliary ducts and bladder. catarrh, thickening, rupture, septic
peritonitis. Symptoms: relapsing colic, with icterus, prostration, and tender right
hypochondrium, in stalled animal on dry feeding. Suggestive: not pathognomonic.
Treatment: as in horse: succulent spring pasturage. In sheep: rare, musky odor;
concretions and casts common in distomatosis. Hypertrophied ducts. Symptoms of
distomatosis. Treatment: for distomatosis and calculi. In swine: rare: circular. In
carnivora: round, dark green, pin’s head to hazel nut. Symptoms: colics,
constipation, emesis, icterus, tender right hypochondrium, concurrent catarrh of
bowels, heart disease, dyspnœa, sudden relief. Mode of relief. Treatment: olive oil,
bile, sodium sulphate, or salicylate, antispasmodics, alkalies, enemata,
fomentations. Laxative food, exercise, open air.

Gall stones are most frequent in animals having a gall bladder.

Some medical writers say they are formed in the gall bladder only,
but the soliped which has no gall bladder has in particular instances
furnished hundreds of gall stones. Yet the ox, dog, sheep and pig are
the common victims of biliary calculi among our domestic animals.
In these the calculi appear to be mostly deposited from the stagnant
bile in the gall bladder, yet concretions on the biliary ducts and
hollow casts inside the ducts are by no means uncommon.
A gall stone may be single, or they may be multiple up to hundreds
or even thousands, and when very numerous they are individually
small, perhaps no larger than a pin’s head. They may, however,
attain the size of a marble or more, and by mutual pressure and wear
they assume various polygonal forms. If they lie apart in the gall
ducts or bladder they are regularly rounded. They are sometimes
mulberry shaped as if conglomerate. In other cases the solid masses
are so small as to have secured them the name of biliary sand. Casts
and incrustations in the ducts are not necessarily made up of smaller
globular masses.
On section a calculus shows a nucleus, composed of bile pigment,
blood, mucus, with the debris of parasites or bacteria. Around this
nucleus the calculus is deposited in concentric layers, of a hard
material consisting largely of cholesterine, but containing also bile
coloring matter, bile salts, and lime, in short all the constituents of
bile.
Causes. Various conditions contribute to the precipitation of
biliary solids in the form of calculi or encrustations. The most
prominent causes are: lack of exercise, overfeeding, dry feeding,
concentration of the bile, the presence of colloids and bacterian
infection.
Idleness is especially operative in cattle, which are quite subject to
biliary calculi and concretions, when shut up in the stall on
abundant, dry feeding for a long winter. They are not noticed in
stalled animals, that are fed watery or succulent rations, such as
green fodder, distiller’s or brewer’s swill, ensilage, brewer’s grains,
mashes, roots, potatoes, apples, pumpkins, and in case a tendency to
their formation is developed on the dry feeding of winter, the
concretions may be re-dissolved and entirely removed by the
succulent spring grass. A similar influence is noticed in the human
family, as the female sex living mostly indoors, and males pursuing
sedentary occupations furnish the greatest number of gall stones.
Concentration of bile results in part from muscular inactivity and
hepatic torpor, but also from overfeeding which loads the portal
blood and indirectly the bile with an excess of solids, and from dry
feeding which lessening the secretion of water leaves the bile more
dense and predisposed to precipitate its solids. The density of the
liquid, however, developed from a rich and dry ration and a
prolonged inactivity, may continue for a length of time, without the
occurrence of actual precipitation. It usually requires some
additional factor to make this predisposition a direct cause.
Presence of Colloids. This may be found in the presence of
solid or semi-solid particles. Just as the introduction of a thread into
a concentrated solution of sugar or salt will induce an instant
crystallization on the filament so the presence of solid bodies
determines a similar condensation in solid form of the solids of the
bile. But this tendency is increased materially if the solid body is
itself of a colloid or non-crystallizable material. Rainey and Ord have
shown experimentally that colloid bodies like mucus, albumen, pus,
blood, epithelial cells, not only determine the precipitation of
crystallizable salts from a strong solution, but that they cause the
precipitate to assume the form of globular or spherical particles,
which by gradual accretions on their surfaces tend to grow into
calculi. They found that salts which are deposited by mere chemical
reaction, without the intervention of colloids, appear in the form of
sharply defined angular crystals. The very fact that a precipitate
assumes a spherical form suggests the presence of colloids as an
active factor in the precipitation. Heat appears to intensify this
action, though probably the normal body temperature operates
mainly through the more active proliferation of bacteria.
Bacteridian infection. In connection with the action of colloids it
has been observed that when such bodies are in a condition of
fermentation they are much more potent as precipitants than if
inactive and sterile. But as all fermentations are the work of
microörganisms we are at once brought to the conclusion that
bacterial infection is one of the most potent causes of calculous
formations. The invading microbes operate upon the dissolved
solids, causing changes in their condition which reduce their
solubility, and thus determine the separation of calculi and
concretions in a manner allied to the precipitation of nitrates in the
soils.
But the same microbes operate in producing the colloids which
coöperate so effectively in the formation of calculi. The catarrhal
biliary ducts, or bladder, shed their epithelium, and transude white
and red globules, and form pus and an excess of mucus, all tending
to the separation of the biliary solids or forming nuclei on which
these solids may condense. The calculi and concretions tend in their
turn to maintain and advance the inflammation.
The access of the microbes to the biliary duct or bladder may be
effected through the blood of the portal vein or hepatic artery, or in
the new-born, through the umbilical vein from an infected navel. As
other modes of access may be named, a gradual advance from the
duodenum through the common bile duct, or more speedily on or in
the bodies of parasites (ascaris, strongylus, stephanurus, tænia,
echinococcus, distoma, fasciola, coccidia), etc.
Changes in the chemical composition of the bile have been
invoked as a cause of gall-stones, and Naunyn has found that the
inflamed biliary epithelium secretes an excess of cholesterine and
salts of lime. Thomas has also observed a great increase of
cholesterine in connection with a catarrhal angiocholitis in the dog.
Among other alleged causes of biliary calculi are advanced age
(Rigot, Hering), acidity of the bile (Zundel), constipation, and any
organic disease of the liver and bile ducts which interferes with
excretion of bile.
Age is supposed to act by inactivity, lessened secretion, hepatic
torpor, and the greater presumption of liver disease, acidity by the
precipitation of cholesterine and the dissolving of lime present in the
tissues, and constipation through hepatic inactivity, obstruction of
the flow of bile, and the tendency to infection through intestinal
fermentations.
It may be added that any diminution of glycocholate or
taurocholate of soda or potash, decreases the solubility of
cholesterine and bile acids and favors their precipitation.
 GALL STONES IN SOLIPEDS.
Characters. The biliary calculi of solipeds are of all sizes and
shapes. When numerous they are mostly the size of a pin’s head
(Lucet). Birnbaum found in one animal 400 like peas. Dieckerhoff
has repeatedly found four or five of the size of a hazelnut. Verheyen
found one as large as an apple and says one exists at the Berlin
Veterinary College which weighs several pounds. Rigot found 90 in
the biliary ducts of an old horse, and Zundel records the death of a
stallion of twenty-six years from multiple gall stones.
The calculi may be little larger than grains of coarse sand. When
larger and solitary they are mostly globular or mulberry shaped; if
many are together they have become polygonal by friction. In other
cases notably with distomata they form hollow tubular incrustations
on the bile ducts, and contain a thick grumous bile. They are usually
of a green color, but may be yellowish brown, yellow, or whitish.
When cut across they present a nucleus enclosed in successive layers,
each successive one often differing from the last in color. Their
specific gravity is low, some will even float in water when taken from
the ducts, and all float when dried. Their composition is variable but
chiefly cholesterine, bile acids, resin and pigments, an albumoid
matter, with lime salts, etc. The nucleus may be the remains of a
dead parasite, epithelial cells, blood, pus, mucus, etc. The outer
layers are usually the hardest.
There may be attendant hypertrophy of the liver, cirrhosis,
amyloid and other degenerations, catarrh of the biliary ducts, and
distension or (according to Birnbaum) rupture of the portal vein.
Symptoms. There are no reliable diagnostic symptoms apart from
the colics which accompany the obstruction of a bile duct by a
passing calculus. These in the main resemble the colic of ordinary
indigestion, but they may be complicated by unusual depression and
nervous prostration. There may be drooping of the head, ears and
eyelids, watery eyes, resting the head on the manger or pushing it
against the wall. The urine is liable to be red or reddish (Jobelot),
and if it or the mucosæ show a yellowish tinge it is strongly
suggestive. There may be constipation or diarrhœa. The colics are
severe and may last for several days (Seaman, Lucet, Burgoin)
without fever and recover abruptly when the stone passes into the
duodenum. They recur, however, with the impaction of another
stone, and this intermittent feature, with the marked prostration,
and the access of slight jaundice with each colic furnishes the best
means of diagnosis.
Treatment. During the access of colic give a full dose (1 to 2 lbs.)
sulphate of soda in warm water along with some active
antispasmodic (belladonna, lobelia, chloroform, ether), and foment
the loins and hypochondriac regions. Olive oil in large doses (1 to 2
quarts) has been found effective. Salicylate of soda in full doses is
beneficial in stimulating the biliary secretion, diluting the bile, and
securing some measure of antisepsis in both bowels and liver.
In the intervals between the colics, sodium salicylate, sodium or
potassium carbonate, or olive oil in continuous doses may assist in
disintegrating the calculi or passing them on. Chloroform tends to
break them up by dissolving the cholesterin. But any such treatment
must be accompanied by the abundant ingestion of water, and this is
often best secured by a run in a rich green pasture. In the absence of
pasturage, succulent fruits, and roots, ensilage, mashes, and gruels
may be advantageously substituted, and conjoined with systematic
exercise in the open air.
 GALL STONES IN CATTLE.
Characters. The biliary calculi of cattle are characterized by a faint
odor of musk, which becomes stronger on the addition of potassa
and the consequent disengagement of ammonia.
They are distinguished according to their color as dark green,
yellowish green, and orange, brownish or white. There are also the
sedimentary deposits (biliary sand).
The dark green calculi are the most frequent, and being found in
the gall bladder and larger bile ducts, they attain a larger size than
the others. Those in the gall bladder may be pear-shaped, and those
in the ducts, round, ovoid or cylindroid. They are often rough and
uneven on the surface with deep cracks and holes penetrating deeply
into their substance and often filled with cholesterin. The pigments
may change to a blood red when dried. The consistency of these
calculi varies, some being hard, resistant and heavy, while others are
soft and friable. All are composed of concentric layers around a
central nucleus as in those of the horse. They vary in weight up to
seven ounces in exceptional cases. They contain cholesterin, fat,
resin, pigments, and lime and magnesia salts.
The yellowish green calculi are usually spherical unless moulded
into polygonal shapes by mutual contact. In the last case they have
flattened surfaces. These have a firm consistency and are composed
of successive layers of nearly equal color and density surrounding the
central nucleus. They are on an average smaller than the dark green
variety but individual calculi have been found of three ounces.
The whitish or orange calculi are usually in the form of hollow
casts of the bile ducts having a dull white color externally and a
yellowish brown internally. They are usually thin, fragile and
crystalline and contain relatively more earthy salts than the two first
named varieties. From this cause also they have a higher specific
gravity. One specimen weighed 8 ounces.
The biliary sand or pulp, is made up of granules of a yellowish,
dark green or black color, forming with the bile a pultaceous mass
but drying into a consistent mass. It may be firmly adherent to the
mucosa of the gall bladder and require to be scraped off. These
granules may be looked on as the first step in the formation of calculi
or encrustations.
The causes of biliary calculi in cattle are mainly close confinement,
dry feeding, abundant rations, the presence of trematodes in the bile
ducts and finally microbian infection.
Lesions vary. With obstruction of the common bile duct or cystic
duct, there are usually dilatation of the bile ducts with fibrous
thickening of their walls so that they stand out as white branching
lines on the back of the liver. In extreme cases the common duct may
acquire the calibre of the small intestine. The gall bladder may
participate in this thickening (Chassaing) or may even rupture
(Proger, Shaw).
In connection with obstruction microbian infection extends
upward into the liver, and in rupture of the bladder an acute, diffuse
septic peritonitis follows (Chassaing). This only follows on infective
inflammation of the gall bladder. Aseptic bile causes little or no
irritation.
Symptoms. As in the horse, general symptoms of ill health or
hepatic disorder are not pathognomonic. The presence of
intermittent attacks of constipation, and colic, with icterus,
tympanies and violent efforts at expulsion are the diagnostic
symptoms of an acute attack. Pulsation and respiration are
accelerated, and the urine dense, high colored, oily and slightly
yellow. Reboul has noticed that symptoms are aggravated on
exposure to cold; there are great prostration and dullness, frequent
moaning and marked indications of tenderness when the right
hypochondrium is percussed. Charlot has observed that the only
symptoms may be persistent jaundice with scanty, high colored
urine, containing some sediment.
Treatment is essentially the same as in the horse. Vanswieten and
Verheyen draw special attention to the fact that whereas biliary
calculi are very common in cattle during winter, they are rarely
found in animals that have been for even a short period on the spring
grass. Spring pasture is therefore the best therapeutic agent. During
paroxysms of colic, Glauber salts, or olive oil, antispasmodics and
fomentations over the liver are to be tried. In the intervals salicylate
of soda, sodium and potassium carbonate, olive oil, chloroform, and
ether may be used. Abundance of water and aqueous rations are
essential.
 GALL STONES IN SHEEP.
Calculi are very rare. One described by Morton had a brownish
yellow color on its surface, and a white color spotted with green
internally; it had a bitter taste, colored saliva yellow, and melted
when heated, diffusing the odor of musk. It weighed twelve grains
and contained 70 per cent. of cholesterin, calcic phosphate and
carbonate and the usual biliary elements.
But if spherical calculi are rare, concretions and casts of the bile
ducts are common, especially in distomatosis. These are of a
yellowish, reddish, greenish or blackish brown, and form granular
plates, or veritable cylindroid casts often firmly adherent to the
mucous membrane of the duct.
In such cases the walls of the encrusted ducts are hypertrophied
and stand out on the back of the liver as white bands diverging from
the portal fissure.
Apart from the usual symptoms of distomatosis no special
indications have been observed.
Treatment is primarily that for distomatosis, to which the general
measures advised for calculi may be added.
 GALL STONES IN SWINE.

Characters. The calculi are spherical, rough or on their opposed

surfaces flat, clear and glistening where they have become polished
by friction. They are found as a fine sand or as calculi the largest of
which have been 75 grains, and of a high density (1303 to 1484).
Bruckmüller found that they contained carbonate of lime and biliary
mucus. Verheyen found biliary resin, mucus, pigment, and a little fat.
They are rare in fat hogs in America. No diagnostic symptoms have
been observed.
 GALL STONES IN DOG AND CAT.
These are more or less spherical, dark brownish green, and usually
found in the gall bladder or larger bile ducts. They may vary in size
from a pea to a hazel nut. Their chemical analysis is wanting.
Symptoms. There may be evidence of biliary obstruction and if
this occurs intermittently and is associated with colic, it becomes
somewhat characteristic. Constipation, emesis, icterus, and
sometimes tenderness of the right hypochondrium would indicate
the source of the colic. A pre-existing and concurrent catarrh of the
bowels corroborates these indications.
Cadeac explains that the obstructing calculus is called on to resist
the impulse of the bile forced upon it by the spasmodic contraction of
the bile ducts, which distends the bile duct immediately back of the
stone to perhaps ten times its normal size. Then under a suspension
of the spasm or even an antiperistaltic contraction of the duct, the
calculus is forced back into the dilated portion or even into the gall-
bladder, and the attack is relieved. Under repeated irritations of this
kind the inflammation of the bile ducts extends into the liver and
determines cirrhosis. The irritation further through the sympathetic
produces a reflex constriction of the pulmonary capillaries, with the
natural results of increasing tension of the pulmonary artery and
right heart, and dilatation and degeneration of the walls of the latter
even in the best nourished animals. Thus dyspnœa and modified
heart sounds (murmurs) may be symptoms of biliary calculi.
Treatment. Three or four ounces of olive oil were found to greatly
increase the quantity and fluidity of the bile in from thirty to forty-
five minutes. Bile, sulphate of soda and salicylate of soda are
excellent cholagogues, and the latter at the same time an antiseptic.
Anti-spasmodics are especially indicated to relieve the colics, but
they must be used in relatively smaller doses than in the herbivora.
Potassic and sodic carbonates or tartrates (Vichy) may be used as
enemas if they cannot be administered by the mouth. Fomentations
may be resorted to. The food must be laxative and aqueous, and
exercise must be imposed as far as the animal can bear it.
 FOREIGN BODIES IN THE LIVER.
In horse: spikes of leguminosæ, barley awns. Symptoms: of internal
hemorrhage, pallor, weakness, vertigo, death; jaundice, prostration, stupor,
weakness, crossing of fore limbs, tender right hypochondrium. In cattle: bodies
passing from rumen. In swine, sand. In dog, sharp bodies from stomach.
Treatment: laparotomy.
Foreign bodies are rare in the liver in our domestic animals.
Horse. St. Cyr has found the spikes of leguminosæ and Megnin the
beards of barley. St. Cyr believed that he traced the passage followed
by the stalk through the walls of the duodenum, and portal vein
where it divided to be distributed through the liver. At the point of
supposed entrance the walls of the vena portæ were thickened and its
lumen filled with clots. The further course of the portal vein and its
branches showed similar thickening and clots, and on the branch
leading to the right lobe was a large abscess containing 4 decilitres of
pus. Clots extended into the splenic, omental and mesenteric veins,
and between the folds of the mesentery of the small intestine were a
number of minute ruptures and blood extravasations.
Megnin found traces of the passage of the barley beards through
the gastric walls and into the substance of the liver close to the portal
fissure. Around the centre where the barbs were implanted there was
an irregular hæmorrhagic extravasation in the liver, and in the
abdominal cavity an effusion of 8 or 10 quarts of blood.
Symptoms. In such a case the only definite symptoms are those of
internal hemorrhage, pallor of the mucous membranes, gradually
increasing weakness, vertigo, unsteady gait, and an early death. In
more protracted cases slight jaundice, dullness, prostration, stupor,
drooping of head, ears and eyelids, resting it on the manger or walls,
muscular weakness, crossing of the front limbs, and it may be
tenderness on percussion on the right side of the chest posteriorly. It
resembles the coma or immobility of the horse but the patient backs
more easily.
Cattle. In ruminants sharp pointed bodies passing from the rumen
will occasionally penetrate the liver, and give rise to symptoms of
hepatic disorder. Augenheister found in a cow dilatation of the larger
bile ducts, which contained about 10 quarts of sand, that had
apparently entered from the duodenum by the common bile duct
which had an orifice of an inch in diameter.
Pig. The gall ducts of a pig’s liver, in the Veterinary College of
Berlin contains a large amount of sand (Gurlt).
Dog. The liver is exceptionally perforated by sharp pointed bodies
coming from the stomach. Cadeac and Blanc report three cases of
needle in the liver. Blanc’s case had been killed because of old age;
one of Cadeac’s showed symptoms resembling rabies.
Treatment of these cases would be very hopeless as nothing short
of laparotomy and the removal of the foreign body would promise
success.
 TUMORS OF THE LIVER. NEW GROWTH.

Largely secondary, from stomach, intestine, lymph glands, spleen, pancreas; the
hepatic tumor may be disproportionately large. In horse: sarcoma rapidly growing
soft, succulent, slow-growing, fibrous, tough, stroma with round or spindle shaped
cells and nuclei. Symptoms: emaciation, icterus, enlarged liver, rounded tumors on
rectal examination. Melanoma, in old gray or white horses, with similar formations
elsewhere; not always malignant. Lymphadenoma. Angioma. Carcinoma.
Epithelioma, lesions, nodular masses, white or grayish on section, and having firm
stroma with alveoli filled with varied cells with refrangent, deeply staining, large,
multiple nuclei, cancerous cachexia and variable hepatic disorder. In cattle:
sarcoma, adenoma, angioma, cystoma, carcinoma, epithelioma. In sheep:
adenoma, carcinoma. In dog: lipoma, sarcoma, encephaloid, carcinoma,
epithelioma. Wasting and emaciation, yellowish pallor, temporal atrophy, ascites,
liver enlargement, tender right hypochondrium, dyspepsia, symptoms of primary
deposits elsewhere.

The great quantity of blood which passes through the liver lays it
open, in a very decided way, to the implantation of germs and
biological morbid products. Hence tumors of the liver are largely
secondary, the primary ones being found mostly in the stomach,
intestine, abdominal lymph glands, spleen and pancreas. The
primary neoplasm is often comparatively small, while the hepatic
one supplied with a great excess of blood may be by far the most
striking morbid lesion. The hepatic tumors are mostly of the nature
of angioma, sarcoma, melanoma, adenoma, lipoma, cystoma,
carcinoma, and epithelioma.
 NEOPLASMS IN HORSES LIVER.
Sarcoma. This is usually a secondary formation from the primary
tumors in the spleen and peritoneum, and it occurs as multiple
masses throughout the substance of the gland. The liver is greatly
increased in size, extending far beyond the last rib on the right side,
and weighing when removed as high as 70 ℔s. (Mason), or even 88
℔s. (Cadeac), in extreme cases.
The whole surface of the liver may show bulging, rounded masses,
and the morbid growth may have involved the capsule and caused
adhesion to the back of the diaphragm (Bächstädt). The cut surface
of the neoplasm is smooth, elastic, yellowish and circular or oval in
outline. It may have a variable consistency—friable or tough,
according to the activity of growth and the relative abundance of cells
and stroma. The portal glands are hypertrophied and thrombosis of
the portal vein is not uncommon.
Microscopic examination of the dark red scrapings shows
numerous blood globules, intermixed with the round or spindle
shaped cells and nuclei of the tumor. Sections of the tumor show
these cells surrounded by a comparatively sparse fibrillated stroma.
The round cells may vary from .005 to .05 m.m. They contain one or
more rather large nuclei and a number of refrangent nucleoli. The
nuclei are often set free by the bursting of the cells in the scrapings.
They become much more clearly defined when treated with a weak
solution of acetic acid. Small grayish areas in the mass of the tumor
represent the original structure of the liver, the cells of which have
become swollen and fatty.
A liquid effusion more or less deeply tinged with red is usually
found in the abdominal cavity.
Symptoms are those of a wasting disease, with some icterus,
sometimes digestive disorder, and a marked enlargement of the liver.
The last feature can be easily diagnosed by palpation and percussion.
If an examination through the rectum detects the enlargement and
irregular rounded swellings of the surface of the liver or spleen, or
the existence of rounded tumors in the mesentery or sublumbar
region, this will be corroborative. The precise nature of the
neoplasms can only be ascertained after death.
Melanoma. Melanosis of the liver is comparatively frequent,
especially in gray horses, and above all when they are aging and
passing from dark gray to white. In many cases a more certain
diagnosis can be made than in sarcoma for the reason that primary
melanotic neoplasms are especially likely to occur on or near the
naturally dark portions of the skin, as beneath the tail, around the
anus or vulva, in the perineum, sheath, eyelids, axilla, etc. The extent
of the disease is likely to be striking, the liver, next to the spleen,
being the greatest internal centre for melanosis. The whole organ
may be infiltrated so that in the end its outer surface is completely
hidden by melanotic deposit. The surface deposits tend to project in
more or less rounded, smooth masses of varying size according to the
age of the deposit and the rapidity of its growth. Individual deposits
may vary in size from a pea to a mass of 40 or 50 lbs. They are
moderately firm, and resistant, and maintain a globular or ovoid
outline. The color of the melanotic deposits is a deep black with a
violet or bluish tint. If the pigmentary deposit is in its early stage it
may be of a dark gray. The deposits are firmer than the intervening
liver tissue and rarely soften or suppurate.
Melanosis in the horse is not always the malignant disease that it
shows itself to be in man, and extensive deposits may take place
externally and considerable formations in the liver and other internal
organs without serious impairment of the general health. It is only in
very advanced conditions of melanosis of the liver that appreciable
hepatic disorder is observed. If, however, there is marked
enlargement of the liver, in a white or gray horse, which shows
melanotic tumors on the surface, hepatic melanosis may be inferred.
Lymphadenoma. Adenoid Tumor. Lienaux describes cases of this
kind in which the liver was mottled by white points which presented
the microscopical character of adenoid tissue, cells enclosing a
follicle and a rich investing network of capillaries.
Angioma. These are rare in the horse’s liver, but have been
described by Blanc and Trasbot as multiple, spongy tumors on the
anterior of the middle lobe, and to a less extent in the right and left,
of a blackish brown color, soft and fluctuating. The largest mass was
the size of an apple, and on section they were found to be composed
of vascular or erectile tissue. The tendency is to rupture and
extensive extravasation of blood (30 to 40 lbs.) into the peritoneum.
Carcinoma. Epithelioma. These forms of malignant disease are
not uncommon in the liver as secondary deposits, the primary
lesions being found in the spleen, stomach, intestine, or pancreas, or
more distant still, in the lungs. The grafting or colonization of the
cancer in the liver depends on the transmission of its elements
through the vena portæ in the one case, and through the pulmonary
veins, the left heart and hepatic artery in the other.
Lesions. The liver may be greatly enlarged, weighing twenty-seven
pounds (Benjamin) to forty-three pounds (Chauveau), hard, firm,
and studded with firm nodules of varying sizes. These stand out from
the surface, giving an irregular nodular appearance, and are
scattered through its substance where, on section, they appear as
gray or white fibrous, resistant, spheroidal masses shading off to a
reddish tinge in their outer layers. Microscopically these consist of a
more or less abundant fibrous stroma, enclosing, communicating
alveoli filled with cells of various shapes and sizes, with large nuclei
(often multiple) which stain deeply in pigments. The relative amount
of fibrous stroma and cells determines the consistency of the mass,
and whether it approximates to the hard cancer or the soft. In the
horse’s liver they are usually hard, and, on scraping off the cut
surface, yield only a limited quantity of cancer juice. In the epithelial
form, which embraces nearly all that have originated from primary
malignant growth in the walls of the intestine, the epithelioid cells,
flattened, cubical, polyhedral, etc., are arranged in spheroidal masses
or cylindrical extensions, which infiltrate the tissues more or less.
These seem in some cases to commence in the radical bile ducts
(Martin), and in others in the minor coats of the larger biliary ducts.
As the disease advances a brownish liquid effusion is found in the
abdomen, and nodular masses formed on the surface of the
peritoneum.
Symptoms. As in other tumors of the liver these are obscure. As
the disease advances there may be œdema of the legs and sheath,
indications of ascites, stiff movements, icterus, occasional colics,
tympanies, and diarrhœa. Nervous symptoms may also appear, such
as dullness, stupor, coma, vertigo and spasms. Emaciation goes on
rapidly and death soon supervenes.
 TUMORS OF THE LIVER IN CATTLE.

Sarcoma. Round or spindle shaped celled sarcomata have been

described by Sodero and Cadeac, leading in one case to perforation
of the vena portæ and death by hæmorrhage into the peritoneum.
Adenoma. Martin records a case of a hepatic tumor formed of
adenoid tissue which had extended into the vena portæ, and
microscopically presented a cylindroid character. In the advanced
stages it caused some jaundice, digestive disorder, obstinate
constipation, progressive and extreme emaciation, and weakness
which kept the animal constantly in a recumbent position.
Angioma. These are rarely seen in the young but are comparatively
common in old cows as they are in aged men. They form masses of a
dark red color and very variable size, and have a limiting sac of
connective tissue or merge into the adjacent hepatic structure.
Microscopically they consist of a series of irregular lacunæ filled with
liquid blood, blood clots, or leucocytes, and communicating with
small blood vessels in the walls and partitions. They are believed to
be formed by dilatation of the liver capillaries with subsequent
thickening of their distended walls, and atrophy of the nearest liver
cells. Cases of the kind have been recorded by Kitt, Martin,
McFadyean, Saake, Van der Sluys, Korevaar and others. Though
often seen in abattoirs, they seem to have little effect on the general
health, and no special symptoms have been noted as indicating their
existence.
Congenital Cysts. These are found on the anterior surface or lower
border of the liver in young calves. They have no connection with the
blood vessels, nor biliary canals, contain no head of larval tænia, and
do not constantly show the presence of any particular bacterium.
These walls are thin and their contents alkaline, with sometimes
slight blood extravasation, or a yellowish deposit in which cocci have